ASSOCIATION OF SCREENING MARKERS OF COAGULATION WITH THE SHORT-TERM OUTCOME IN THE SMALL BOWEL OBSTRUCTION IN ADULTS: A RETROSPECTIVE STUDY.

Abstract

The aim: To evaluate the possibility of using screening markers of coagulation to the assessment of severity and predict short-term outcomes in patients with small bowel obstruction. Materials and methods: The study was based on the results of treatment of 71 patients 18-60 years old in 2019-2021. Patients were divided into two groups: in the 1st included those with a positive outcome (90.1%), and in the 2nd those with adverse outcomes (9.9%). Results: Only the laparoscopy approach has been in 12.5%, the laparotomy in 78.9%, and the hybrid in 9.9% of patients. There were no significant differences in screening tests of coagulation function indicators, including D-dimer, fibrinogen, Activated Partial Thromboplastin, International Normalised Ratio levels, and the International Society on Thrombosis and Hemostasis Criteria (ISTHC) score in two groups of patients before surgery. The predictive value of preoperative Sequential Organ Failure Assessment (SOFA) data (AUC = 0.844), serum lactate (AUC = 0.805), and systolic blood pressure (SPB) data (AUC = 0.808) before surgery were significant. The SOFA (AUC = 0.844) and APACHE II scores (AUC = 0.802), serum lactate (AUC = 0.884), D-dimer (AUC = 0.812), Antithrombin (AUC = 0.815), and CRP (AUC = 0.856) levels, SPB (0.856) within the first 72 hours after surgery were also good predictors of short-term outcomes (P = 0.000). Conclusions: It was confirmed that three parameters were predictors of early mortality before surgery, none of them included parameters of coagulation and seven parameters via 72 hours after surgery, which had included some parameters of coagulation.